Elder Care: An Unavoidable Issue for Everyone

Author Cynthia Wilson explains why and what we need to do

More than 42 million Americans serve as care givers for an elderly or disabled adult, according to a 2009 survey by AARP. During the same year, an additional 61.6 million people provided some type of care for the elderly. According to the AARP report, the estimated economic value of these unpaid contributions was approximately $450 billion in 2009, which was up from an estimated $375 billion in 2007.

InvestorPlace recently talked with Wilson to find out how to best prepare for taking care of an aging loved one. Following are edited excerpts from that conversation.

Q: In a nutshell, what is Who Will Take Care of Mom? all about, and for whom did you write it?
A: It’s a guide for providing long-term senior care at home for a relative or yourself in a way that doesn’t sacrifice the treatment and safety you expect when you age, your financial stability or your family’s wealth.

So it was written for two audiences — people currently providing care for a relative or loved one who is elderly, disabled or terminally ill; and people who want to plan their senior care and protect their families from financial ruin.

Q:You also have a personal reason for writing the book. Please tell us more about that.
A: I’ve been taking care of my mother at home since 1999. So I tap into that personal experience to illustrate how elder care can impact a family’s finances, even when you are not the person receiving elder care services. But it’s written in a way to show readers that we all will be affected by issues related to aging. There’s really no escaping it.

Q: What’s the most important takeaway you want readers to get from the book?
A: I want readers to understand that it is in their family’s emotional and financial interest to provide or coordinate a relative’s health care. Doing so ensures that the relative is cared for the way the family wants and expects, and that the family doesn’t lose all of its wealth because it avoided planning how to care of a parent or relative during their senior years.

Most states now allow health care providers to sue adult children to recover their parent’s health care debt and long-term care debts. We should all know and understand how that reality can affect families and our nation’s economic prosperity for generations.

Q: You talk about the “penalty of getting old.” What do you see that penalty as being?
A: Simply stated, we cannot afford to pay for everything that comes along with aging. Yet we are living longer, and we have to do it on fixed incomes while the cost of food, shelter and health care goes up.

Also, as most everyone knows, the government programs for seniors and disabled people are in trouble because when they were created, we weren’t expected to live as long as we are. The safety nets people thought they could rely on 20 years ago are not going to be there, at least the same level of support will not be there. And neither are the 401(k) and IRA savings people once counted on because people lost a lot of their wealth thanks to the subprime mortgage mess.

If that’s not bad enough, many older people are having a hard time finding work either because the jobs aren’t there or because employers prefer younger workers who may bring more technology skills to the job for less pay. Studies show that even people in their late 40s are having a hard time finding employment.

Q:What effects do you think current political discussions are having on the subject of elder care in America?
A: As a country, we are discussing senior health care issues, and while it’s good to have that discussion, it’s discouraging that we’re not coming to any agreement.

In my opinion, the problem is too far along to expect that it will be solved by just cutting spending or just raising taxes. We need to do both. We have the largest generation of Americans retiring over the next 20 years. The size of the workforce that is going to replace those retiring workers is smaller than it has been in a past.

That’s a problem because the Medicare fund is supported by the workforce. There will not be enough workers paying into the system to keep it solvent under its current payout plan. We’re going to have to pay more, and we’re going to have to cut out the waste. We have to come together and make sacrifices on both ends.

Q:You write about bad habits that increase health care costs. What are they, and how are they hurting senior care?A: Most Americans don’t eat right or properly take care of themselves. That’s a big problem. Also in general, we don’t save enough, and we don’t ask how much routine tests and doctor visits cost. Most people won’t go through a drive-thru to buy a hamburger without checking the price, and yet too often people go to the doctor’s office and don’t ask questions about the cost of treatments and procedures … especially if they have insurance.

We should be able to compare costs and decide for ourselves if the differences in prices for the same procedure are a premium for a level of expertise or an office location. We should make sure that patients are getting the best price for the procedures they need, even if they have insurance.

Q:You talk about a greater need for health care providers to be more transparent when it comes to health care costs. What do you think needs to be done to ensure more transparency?A: We should know how much your doctor’s visit cost, and not just the co-pay. We should question whether a procedure is really needed. I’m not discouraging people from getting the procedures they need, I just want to encourage everyone to ask the important questions.

I once asked a health care provider who books appointments how much their service cost. Her response was a question: “Do you have insurance?” When I said yes, the provider said, “OK then, you are covered.” I told her that it wasn’t just about having insurance. I had deductibles and co-pays to consider as well. So, I needed to know what they charged because I have to pay a percentage of the costs.

The provider didn’t even know the price. I eventually got an answer but not immediately. These are the questions we need to keep asking. I don’t think that we’ll get our health care spending under control, as a country or individually, if we do not even know how much our health care service really costs.

Something that is helping transparency are Walgreen’s and CVS walk-in clinics. These stores list the prices for medical services like flu shots. Those price lists help encourage consumers to ask their health care provider for his/her prices. So, that moves the industry forward regarding transparency.

Q:What’s your top advice for people when it comes to taking control of their health care?A: I encourage those in my age group to start thinking about their current health issues and how their health may affect their care needs in the future.

For example, if someone is a diabetic at age 42 or has high blood pressure in her mid-30s, those problems could get worse as you age. So, ask yourself, am I going to be in a position to maintain my health in the long term? Can I continue to afford the care I’ll need and my current lifestyle?

And then think of those same issues regarding your parents. Start planning now. Talk to your doctor about how a disease like diabetes will affect you or a parent as they age. Start identifying potential living arrangements and caregivers now. You may need them sooner than you think.